Mental illness survey defies popular myth

By Hope Green

Thirteen years ago, Bill Lichtenstein's manic-depressive
condition triggered episodes of delusion and paranoia so
severe that he was hospitalized for weeks at a time. But
after a lengthy rehabilitation process, the former ABC News
producer went on to launch an award-winning independent
production company in New York, where he manages a staff of
10, juggles multiple radio, video, and television
documentary projects, and is responsible for raising and
spending $1 million a year.

It is possible that Lichtenstein's underlying condition
will never go away. But by keeping a flexible work schedule
and acknowledging his disorder, he has been able to continue
pursuing the career of his choice.

The story of the producer is not an unusual case,
according to a recent survey conducted at Boston
University's Center for Psychiatric Rehabilitation.
Researchers say their study of 500 professionals with
ailments such as bipolar disorder, schizophrenia, major
depression, and post-traumatic stress disorder demonstrates
how talented individuals can overcome the limitations of
severe psychiatric illness and fulfill their potential in
the workforce.

"I live with this illness and take medication just as
somebody with diabetes takes insulin," says the president of
Lichtenstein Creative Media and coproducer of The Infinite
Mind, National Public Radio's weekly program that explores
issues of the human psyche. "I don't have to be so
overwhelmed by my symptoms that I can't lead a full life."

Besides Lichtenstein, survey respondents included nurses,
administrators, lawyers, and even corporate CEOs. A majority
of the group, 62 percent, had held their current position
for more than two years, and 73 percent worked full-time.
Many had been hospitalized within the past three years.

Although the researchers were unable to poll a random,
statistically representative sample of such professionals,
they say their findings help to shatter myths commonly held
by the public, employers, and even psychotherapists.

"While past studies have focused primarily on
dysfunction, this is the first study of its kind to open a
window on a previously unexplored area: how people, despite
a disabling mental illness, have fashioned an enduring,
well-paying, and meaningful professional or managerial
career," says Zlatka Russinova, codirector of the study and
a senior research associate at the center, a wing of BU's
Sargent College of Health and Rehabilitation Sciences. "This
research provides hope for others who are combating personal
and societal barriers as well as stereotypes about the
impact of serious mental illness on careers."

An estimated 2.6 percent of Americans, or 5.5 million,
have a serious and persistent mental illness, according to
the National Institute of Mental Health. Despite the
introduction of increasingly effective drugs during the last
decade, the BU researchers say, many psychologists and
psychiatrists still take a traditionally pessimistic
attitude toward their patients' prognosis for recovery, and
steer even those with high intelligence and education toward
repetitive, low-skill, low-wage jobs. But as the study
participants can attest, such typecasting is out of date.

"It is true that we conducted our study with the goal of
changing people's attitudes," says Marsha Langer Ellison,
the project's director and a SAR adjunct assistant
professor, "but we did not know how many people we would
find or what kinds of challenges they were facing in the
workplace. There is plenty of suffering, but the astonishing
thing about this group is that they have succeeded in their
careers nonetheless."

"We don't want to present this as a garden of roses,"
adds Russinova. "These people still have to be in treatment,
and they still have to cope with their illness. But we were
struck by their unusual resilience. They really are heroes
to be able to do this."

Survey respondents most frequently cited psychotropic
drugs, regular talk therapy, and the support of a spouse or
partner as factors that help them cope with daily pressures.
Many also benefit from a flexible work schedule and the
ability to take short breaks. Often such flexibility is part
of company policy. But in many cases, employees find it
necessary to disclose a psychiatric condition to supervisors
and colleagues, as did 86 percent of those surveyed.

Bill Lichtenstein (with camera),
president of Lichtenstein Creative Media, directs a
crew on one of his company's video projects. He is
one of 500 participants in a BU survey of
professionals with psychiatric conditions.

"People with mental illness tend to succeed in an
environment that has some level of understanding and
tolerance, and provides accommodations so they can handle
their illness," Ellison says. "Nearly all of the people we
surveyed were given flexible duties, schedules, and
locations for their work."

Respondents were asked what factors of their illness
present them with the greatest job-related challenge. A
large number reported feeling uncomfortable about asking
supervisors for adjustments in their routine, and said they
worried about fitting in with the prevailing office culture.
One survey participant, a senior technical editor in San
Jose, Calif., who asked that her name not be used, says that
she is "extremely lucky" that her boss allows her to work at
home when her manic-depressive symptoms flare.

"Most people with this condition become sleepy. I have
atypical symptoms -- I get extremely angry and hostile,"
says the editor, who has worked at her company for 10 years.
"Sometimes I need to leave or I'm going to yell at
somebody." Often she finds that a walk around the block is
sufficient, and she can calmly return to her desk.

Lichtenstein says it would be impossible for him to
function if he could not be candid about his illness. "This
is an issue that the mental-health community has not
explored: it's phenomenally stressful to feel you have to
stay in the closet," says Lichtenstein, a Brookline native
and son of Bernice Lichtenstein (SON'59). "The fear of what
would happen if you were discovered is enough to make you
sick."

Russinova and Ellison, whose project is funded by
research grants from the National Institute on Disability
and Rehabilitation Research and the Center for Mental Health
Services, plan to conduct a second, larger phase of the
study, which will track participants for two years. They
expect to produce evidence that gainful, intellectually
challenging employment can help to keep chronic psychiatric
ailments under control.

"The recovery process tends to stimulate one's ability to
work," Russinova says, "but returning to work also helps
people with mental illness get better. These things are
definitely interconnected."